MEDICARE: MICHAEL CZAR PT,DPT, ATP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1208207	TX
2	225CA2400X	Assistive Technology Practitioner Rehabilitation Counselor	92775	TX

General Provider Information

NPI Number	:	1518245455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CZAR PT,DPT, ATP

Provider Business Mailing Address
First Line	:	2111 FM 1960 RD E
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-5229
Country	:	US
Telephone Number	:	832-445-0956
Fax Number	:	832-777-7023

Provider Business Practice Location Address
First Line	:	2111 FM 1960 RD E
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77338-5229
Country	:	US
Telephone Number	:	832-876-1104
Fax Number	:	210-922-8304

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2011
Last Update Date	:	10/19/2020

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